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The nursing process: A supportive model for nursing students’ learning during clinical education - A qualitative study
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.ORCID iD: 0000-0003-1522-275X
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-3400-323x
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-8842-7759
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-7140-625x
2023 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 72, article id 103747Article in journal (Refereed) Published
Abstract [en]

Aim

The aim of this study was to increase understanding of nursing students’ learning during clinical education in relation to the nursing process.

Background

Nursing students’ learning during clinical education is of great importance in creating meaning for theory and development of core competencies. As a theoretical model, the nursing process is challenging to apply in practice for both students and registered nurses, although use of the model has benefits for patient care.

Design

This is a descriptive qualitative study with an abductive approach. Methods: Twelve semi-structured interviews with nursing students in education from six universities in Sweden were conducted in 2021–2022. Data were examined using qualitative content analysis.

Results

The results revealed that the nursing process supported learning when theory and practice ‘spoke the same language’. This allows for the opportunity to perform in a consistent way with the theory, while obtaining awareness of an invisible process. Furthermore, the nursing process supported learning by incorporating a thought structure for the student´s professional role through developing independence to conduct a holistic assessment and increasing an understanding of the nurse´s area of responsibility.

Conclusion

The results revealed that when theory and practice were aligned, the nursing process became a meaningful structure to develop a sustainable, safe way of thinking for one's future professional role. It is important to use supportive pedagogical models for students and supervisors that facilitate the integration of concepts of the nursing process in practice.

Place, publisher, year, edition, pages
Elsevier Ltd , 2023. Vol. 72, article id 103747
Keywords [en]
Abductive approach, Clinical competence, Clinical education, Learning, Nursing process, Nursing student, Qualitative content analysis, Supportive model
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-101336DOI: 10.1016/j.nepr.2023.103747ISI: 001067171100001PubMedID: 37634290Scopus ID: 2-s2.0-85169793516OAI: oai:DiVA.org:ltu-101336DiVA, id: diva2:1796687
Note

Validerad;2023;Nivå 2;2023-09-13 (joosat);

CC BY 4.0 License

Available from: 2023-09-13 Created: 2023-09-13 Last updated: 2025-12-15Bibliographically approved
In thesis
1. The nursing process – A core structure for nursing students’ development of clinical competence: From the perspective of nursing students, supervisors and teachers
Open this publication in new window or tab >>The nursing process – A core structure for nursing students’ development of clinical competence: From the perspective of nursing students, supervisors and teachers
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Clinical education is the part of the nursing education wherein students gain experiential and practical knowledge in real clinical settings. It is essential because it allows nursing students to develop clinical competence by applying and integrating theoretical knowledge through patient encounters. The nursing process is a component of clinical competence and a systematic approach to providing care which involves critical thinking. The overall aim of this thesis was to explore how the nursing process can support nursing students’ learning and development of clinical competence during clinical education. The thesis takes a qualitative research approach and consists of four interrelated studies, each designed to correspond to different aspects of the overall aim: qualitative descriptive design (I), focus group methodology (II), grounded theory (III) and qualitative longitudinal intervention study (IV). Data were collected through individual interviews (I, III, IV) and focus group discussions (II, III). The included participants were nursing students in their final year (I, III, IV), supervisors in clinical settings (II, III), clinical teacher (III) and teachers in nursing education from higher education (III). Data were analysed using qualitative content analysis (I), focus group methodology (II), constant comparative analysis (III) and pattern-oriented analysis (IV). For addressing the overall aim, an interpretative synthesis was conducted to form a comprehensive understanding of the findings from all the sub-studies. 

The overall findings show that the nursing process can provide a core structure for nursing students’ learning and development of clinical competence during their clinical education. The nursing process can serve as a framework for reflection and help students give meaning to theory in practice. Through reflection and a deeper understanding of the nursing process in practice, students can adopt a more structured approach to their clinical work, which strengthens their clinical competence. However, for learning based on the nursing process to be meaningful, students must receive sufficient support and experience the necessary prerequisites. A reciprocal relationship between the student and the supervisor is significant, as both have the responsibility to create conditions for learning and development. In addition, students’ understanding and holistic view of the patient were enhanced when they were given the opportunity to consider the entire nursing process. A clinical education grounded in person-centred learning and reciprocal supervisory relationship offers a conducive environment for students to grow and enhance their clinical competence in becoming a nurse. 

In conclusion, the nursing process appears to be a valuable structure in nursing students’ learning during clinical education. Nursing students need support from supervisors and teachers to make the process meaningful in practice. These findings have implications for educators in nursing programmes and supervisors in clinical practice with regard to structuring and improving clinical education. 

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2026
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Keywords
clinical competence, clinical education, nursing, nursing education, nursing student, nursing process, supervision, qualitative research
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-115809 (URN)978-91-8048-970-6 (ISBN)978-91-8048-971-3 (ISBN)
Public defence
2026-02-27, A117, Luleå University of Technology, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Luleå University of Technology, 622940
Available from: 2025-12-15 Created: 2025-12-15 Last updated: 2026-02-06Bibliographically approved

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Löfgren, UlrikaWälivaara, Britt-MarieStrömbäck, UlricaLindberg, Birgitta

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